MEMBERSHIP INVESTMENT SCHEDULE       Business Name________________________________________________________ Your Name____________________________________________________________ Address___________________________________Phone No.____________________   City____________________State_______________Zip_________________________   Fax No.___________________Email Address:________________________________   Total Employees?____________Full Time?_____________Part Time?_____________   Webpage____________________________________________________   Business Description_____________________________________________________ (for Membership Directory)   Voting Representative Name______________________________________________   PLEASE MARK THE APPROPRIATE MEMBERSHIP CATEGORY   ______Regular Business Membership               1-25 Employees  $65 + $5 each FT emp./$2.50 each PT emp.             26-50 Employees  $65 + $4 each FT emp./$2.00 each PT emp.             51-99 Employees  $65 + $3 each FT emp./$1.50 each PT emp.           100 +   Employees  $65 + $2 each FT emp./$1.00 each PT emp.   ______Corporate Sponsor-Business located outside Centralia but doing business in             Centralia, having no public outlet in Centralia.             $125 per year   ______Associate Membership-Any individual, resident or non-resident             $25 per year   ______Chamber Partners-Any Club or Organization             $35 per year   PLEASE RETURN YOUR CHECK ALONG WITH THIS FORM